Seizure during embolization of arteriovenous malformation
S. Bharati, T. Chowdhury, K. Goyal
2012
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Journal
Saudi Journal of Anaesthesia
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Key Takeaway Key Takeaway: A seizure during embolization of an arteriovenous malformation was managed with additional phenytoin and valproate, and the patient was discharged without neurologic deficits.
Abstract
(pH 7.33, PaO2 380 mmHg, PaCO2 40.9 mmHg, bicarbonate 21.8, and base deficit 4.3). Blood sample for measuring plasma level of antiepileptic agents was dispatched and an additional dose of phenytoin was administered. Check angiography showed partial obliteration of AVM with the large venous pouch still filling. Non‐contrast computed tomography (NCCT) head did not reveal any hemorrhage. The procedure was abandoned and the patient was shifted intubated to the intensive care unit (ICU). The plasma level of valproate was found to be within the therapeutic range. Continuous electroencephalography monitoring in the ICU for the next 48 h did not reveal any seizure activity. Tracheal extubation was performed after 18 h of elective ventilation. Repeat NCCT head after 24 h was normal (no evidence of hemorrhage or infarction). The patient was discharged on the fourth postoperative day without any neurologic deficit.